Evaluation of relation between serum iron, ferritin, transferrin saturation, hepatic iron deposition and liver histopatology and, viral load in patients with chronic hepatitis C

The aim of this study is to search the effects of serum iron, ferritin, transferrin saturation and hepatic iron deposition for the liver fibrosis and inflammation in patients with chronic hepatitis C (CHC).The records of 70 patients with CHC who had not previously been treated with antiviral therapy were reviewed retrospectively. The liver biopsies of these patients have been scored in terms of inflammation and fibrosis with the method of modified ISHAK by only one patholog. Preparations were prepared from these liver biopsies were stained with Persl' Prussian blue. Hepatic iron deposition was evaulated using the method of semicantitative modified MacSween by the same patholog. The patients? simultaneous serum iron, total iron binding capacity, ferritin and transferin saturation have been screened retrospectively.In the histopathological evaluation of liver biopsy samples, increased hepatic iron deposition has been found in 25 patients (38.5%). A significant relation has been found between increased hepatic iron deposition and histological activity index (HAI) (p=0.001), but not found fibrosis degree (p>0.05). Fibrosis and HAI degrees were higher in patients with severe-moderate hepatic iron deposition. A significant relation has been found between increased hepatic iron deposition and viral load (p=0.009), older age (p=0.048). The CHC patients with severe hepatic fibrosis were significantly older than mild fibrosis patients. There was a significant relation between ferritin and hepatic fibrosis (p=0.010) and, HAI (p<0.028).A positive correlation was found between ferritin and hepatic fibrosis. On the one hand there was a significant relation between AST and hepatic fibrosis (p=0.011), on the other hand a significant relation between ALT and hepatic inflammation (p<0.028). AST and ALT values of severe fibrosis and moderate HAI were higher than mild groups.In conclusion; Increased hepatic iron deposition may be associated with severe hepatic fibrosis and inflammation in patients with chronic hepatitis C. The serum ferritin value may be used as a predictor of severity of hepatic fibrosis and grade of inflammation.